Individual provider Active NPI

Karie L. Mann, LISW

  • Clinical Social Worker
  • Beavercreek, OH
National Provider Identifier
1164741773
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0900155 Issued in OH
Practice address
1330 Parkway CT
Beavercreek, OH 45432-2601
Phone
(937) 401-0055
Fax
(937) 853-3020
NPI assigned
May 21, 2010
Last updated
Jan 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0900155 OH Primary

Addresses

Primary practice location

1330 Parkway CT
Beavercreek, OH 45432-2601

Mailing address

1330 Parkway CT
Beavercreek, OH 45432-2601
Phone (937) 401-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200724000381 OH Practitioner - Clinical Social Worker 1052735917 Practice locations: Beavercreek, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1330 Pkwy CT
Beavercreek, OH 45432-2601
Phone (937) 401-0055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0900155OHMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1164741773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 PARKWAY CT",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322601",
            "telephone_number": "937-401-0055",
            "fax_number": "937-853-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 PARKWAY CT",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322601",
            "telephone_number": "937-401-0055",
            "fax_number": "937-853-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "KARIE",
        "middle_name": "L.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0900155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.